Health: Drinking Yourself Skinny

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Programs generally require patients to be from 15% to 30% above normal weight in order to qualify. However, these standards may not always be adhered to. Says Ann Coulston, a senior research dietitian at Stanford University Medical Center: "The institution offering the program is eager to get as many people as possible for revenue-generating purposes. People may get admitted who don't meet the criteria." Some experts would prefer to see the diets used only for very obese patients, those who are at least 50% overweight.

The biggest debate, however, concerns whether the swift weight losses are permanent. Patients who finish these programs (and 30% to 40% do not) lose an average of 60 lbs. to 70 lbs., but some regain their weight rapidly. Michael Workstel, a printer from Milford, Pa., lost 120 lbs. twice, only to put it back on. Why? "Because you don't change your eating habits," says Workstel. "When you're doing a liquid diet, there are no choices. You're in a bubble."

New York City's most famous dieter, Mayor Edward Koch, lost weight on a VLCD earlier this year and promptly regained it. Worse, he described the formula as "swill." Still, doctors say liquid diets may offer a lasting answer for the very obese. Notes Dr. Albert Stunkard of the University of Pennsylvania: "This is a reasonable way to lose weight. Whether it's better than losing weight slowly over a long period of time we really don't know."

At the end of a liquid diet, patients have to return to the all too tempting world of food and the all too easily avoided reality of exercise. That is when the real test comes, says Ted Schilling, 42, an attorney in Osterville, Mass. A veteran of "every diet you could be on," Schilling took to heart the behavioral-modification classes he attended while losing 100 lbs. A year and a half later, his weight is still off. Says Schilling proudly: "I'm living a normal life with food now."